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Contact Information

PEDIATRIC CARDIOLOGY SERVICES LLC
1380 MILSTEAD AVE NE
SUITE J
CONYERS, GA30012-3864
 Phone: 770-995-6684
 Fax: 770-995-7631
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC CARDIOLOGY SERVICES LLC

NPI # 1467613232
LBN Legal business name PEDIATRIC CARDIOLOGY SERVICES LLC
Authorized official KIM WOODY - (PRACTICE ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/24/2008
Last updated 06/24/2008 - About 18 years ago
Identifiers
GA License # 043298
GA Medicaid 000326873G
GA Medicaid 00740891A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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